This proposal requests a supplement to the recommended level of funding for the patterns of care study in its sixth year. Approval of this proposal would essentially continue funding at the level already provided for the fifth year. We specifically request continuation of support for the following programs: Multi-disciplinary approaches, education, utilization of professional personnel and referral patterns, and survey. These programs form vital components of the total PCS effort. The multi-disciplinary program of the patterns of care study proposes to mount a joint study with the College of American Pathologists to determine the feasibility of a nationwide quality control review of pathology records. We continue to communicate with other oncologic specialists concerning possible similar reviews in their disciplines. In the area of education, substantial progress has been made as the PCS findings have become clear. The educational program is extremely important because it is the chief means to communicate these findings to the medical community. In utilization of professional personnel and referral patterns, it has proven difficult to quantify, for analytical purposes, the effects of the environment in which radiation therapy is practiced. Yet, knowledge of such effects promises a major impact on our future efforts. In the area of survey, we plan, during the coming year, a survey of institutions to augment our outcome data base and thereby increase the efficiency of our analytical efforts. We plan also to survey selected institutions to evaluate the effectiveness of other PCS programs. In addition to these programs, we will naturally be continuing all other aspects of the study which have been recommended for funding.